Unique Challenges Young Adults Face While Going Through Cancer Treatment - Part 1, Fertility

When you hear someone talk about breast cancer, you don’t typically think of an otherwise healthy young adult in their 20’s… at least that was never what I thought of, until now.  

After my breast cancer diagnosis in March of this year, I did what everyone would do… I turned to the all-powerful Google machine to give me all of the information that I would need to navigate this uncertain journey ahead of me. And while I did find some super helpful information, I also noticed a glaring gap in information that I was looking for. I couldn’t help but notice the scarcity of information and resources specifically for young adults with breast cancer. I am considering under 40 as my young adult threshold.

There are some unique obstacles that young adults battling breast cancer face that the older more ‘typical’ breast cancer patient may not necessarily have to go through.

1. Early Menopause - a common side effect of chemotherapy treatments is that it can cause your body to go into menopause earlier than it naturally would have occurred, aka medical menopause. According to breastcancer.org, “At the same time that chemotherapy destroys fast-dividing cancer cells, it can be harmful to your ovaries, which also contain rapidly dividing cells that produce eggs. Depending on how old you are and what types and dosage of medications you have, your ovaries may or may not recover from this damage. Your periods may stop temporarily during chemotherapy or they may stop for good. The older you are, the higher the risk that this menopause will be permanent.”

If you’re like me and you’re in your 20s’, menopause is not even remotely on my radar of things that I would have to worry about in the near future. That changed after I was diagnosed, and I was forced to start thinking about and preparing myself mentally for the possibility that my body could go through early menopause due to my chemo treatments. With that being said, there are some studies that do suggest “that anywhere from 0-40% of women under age 40 go into permanent menopause as a result of chemotherapy.”

 For me personally, I was able to start on a medication called Zoladex, which essentially pauses or temporarily shuts down your ovaries’ production of estrogen. This medication is used if you are premenopausal and have hormone receptor positive breast cancer. The hope with this medication is that it will ‘pause’ my ovaries while I am going through active treatment. Once I stop receiving this medication, the hope is that my ovaries will begin functioning again as normal. The younger you are, the higher chance that your ovary functionality and estrogen levels will return to normal after you stop taking the medication, though the timeframe on how quickly that happens varies from woman to woman.

2. Fertility - Another unique challenge that younger breast cancer fighters face that is related to early menopause, is the chance of fertility issues. Obviously if you go into medical menopause, temporarily or permanently, you will certainly face some fertility issues. And even if your ovary functionality bounces back after treatment, there is still a chance that your eggs were damaged from the chemotherapy drugs.

Before beginning active chemotherapy, there are steps you can take to manage potential fertility issues. One of the most common things to do is to freeze your eggs before they have the chance to be damaged by the toxins that will soon be pumped into your body via chemo. Freezing your eggs may or may not be a viable option for you depending on your own unique set of circumstances. If fertility issues are a major concern of yours, talk with your medical team about what your options are before starting your chemotherapy treatments.

For my unique breast cancer case, I spoke with my medical team about my fertility concerns, and we came up with a game plan that we felt was the best for me at the time. Due to my cancer being grade 3, the most aggressive kind, we wanted to start chemotherapy treatments as soon as possible. This meant that I didn’t have the time needed in order to go through the steps to freeze my eggs. We opted to go with the Zoladex injections to pause my ovaries while going through treatment in the hopes that we can try to protect my eggs from the damage of chemotherapy. Only time will tell if I will have any long term fertility issues, but worst comes to worst, there is always adoption or other alternative ways to start a family.

These are just two of the many unique challenges that younger adults face when going through treatment for breast cancer. There are many more that I will cover in future blog posts!

Fiercely,

Jesse